{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T18:06:49Z","timestamp":1777486009204,"version":"3.51.4"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T00:00:00Z","timestamp":1705968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82072517"],"award-info":[{"award-number":["82072517"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013290","name":"National Key Research and Development Program of China Stem Cell and Translational Research","doi-asserted-by":"publisher","award":["2019YFE0126300"],"award-info":[{"award-number":["2019YFE0126300"]}],"id":[{"id":"10.13039\/501100013290","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005089","name":"Beijing Municipal Natural Science Foundation","doi-asserted-by":"publisher","award":["7192195"],"award-info":[{"award-number":["7192195"]}],"id":[{"id":"10.13039\/501100005089","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Osteonecrosis of the femoral head (ONFH) is a disease that occurs frequently in young and middle\u2010aged people. Because of its high disability rate, it affects the ability to work, so the early treatment of this disease is particularly important. This retrospective study aimed to evaluate the clinical efficacy of hip arthroscopy combined with multiple small\u2010diameter fan\u2010shaped low\u2010speed drilling decompression (MSFLD) in treating early\u2010mid stage ONFH (ARCO II\u2010IIIA) compared to MSFLD, with at least 10\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 234 patients who underwent hip arthroscopy and MSFLD for ONFH from 1998 to 2012 were analyzed retrospectively. This study enrolled patients between 18 and 60\u2009years old with ARCO stage II\u2010III A, diagnosed clinically and through imaging, in accordance with the 2021 guidelines for the treatment of ONFH. Clinical data, including demographics, operation mode, BMI, pre\u2010 and postoperative Harris score, and femoral head survival rate, were collected. Patients were divided into hip arthroscopy + MSFLD and MSFLD groups based on the operation mode. The t\u2010test was used to compare the postoperative efficacy, Harris scores, and survival rates of the femoral head between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 234 patients, 160 cases were followed up, including 92 cases in the hip arthroscopy + MSFLD group and 68 cases in MSFLD group, the follow\u2010up rate was 68.38%, and the follow\u2010up time was (10\u201322)14.11\u2009\u00b1\u20093.06\u2009years. The Harris score (80.65\u2009\u00b1\u20096.29) in the hip arthroscopy + MSFLD group was significantly higher than that in the MSFLD group (<jats:italic>p<\/jats:italic>\u2009=\u20090.00), and the survival rate of femoral head (5\u2010year survival rate was 84.78%, 10\u2010year survival rate was 23.91%) was also higher than that in the MSFLD group (5\u2010year survival rate was 63.24%, 10\u2010year survival rate was 8.82%). The 5\u2010year and 10\u2010year survival rates of patients with ARCO II were 82.11% and 28.42%, which were better than 54% and 33% for ARCO III A. The femur head survival rate of alcoholic ONFH (5\u2010year survival rate 61.54%, 10\u2010year survival rate 9.23%) was significantly higher than that of other types of ONFH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Clinical follow\u2010up of at least 10\u2009years suggests that hip arthroscopy combined with MSFLD is an effective treatment for early\u2010mid stage ONFH, with good clinical effect and high survival rate of femoral head.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13985","type":"journal-article","created":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T07:19:48Z","timestamp":1706080788000},"page":"604-612","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Hip Arthroscopy Debridement Combined with Multiple Small\u2010Diameter Fan\u2010Shaped Low\u2010Speed Drilling Decompression in the Treatment of Early and Middle Stage Osteonecrosis of the Femoral Head: 14\u2009Years Follow\u2010Up"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5181-9599","authenticated-orcid":false,"given":"Gang","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Orthopedics, The No.4 Medical Centre Chinese PLA General Hospital  Beijing China"},{"name":"Department of orthopaedics Chinese PLA 984 Hospital  Beijing China"},{"name":"Medical school of Chinese PLA  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5949-9545","authenticated-orcid":false,"given":"Yujie","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The No.4 Medical Centre Chinese PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongjun","family":"Zheng","sequence":"additional","affiliation":[{"name":"Medical school of Chinese PLA  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6071-9429","authenticated-orcid":false,"given":"Mingxin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The No.4 Medical Centre Chinese PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0602-2599","authenticated-orcid":false,"given":"Zhongli","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The No.4 Medical Centre Chinese PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6979-2526","authenticated-orcid":false,"given":"Chunbao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The No.4 Medical Centre Chinese PLA General Hospital  Beijing 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